Patient Forms – Dental Matrix Chino Hills

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Patient Forms

Please print, complete, and bring these forms to your appointment!

Patient Information Sheet

Review of Patient System

Sleepiness Scale Questionnaire

CBCT Scan Informed Consent

Notice of Privacy & Consent

Dental Matrix takes pride in providing the best care to beautiful faces inside and out by using holistic or natural modern technology. A total makeover from your airway, teeth, gum, face and chin. We offer Evoke, hands free, pain free face and chin lift, no needle and no surgery by using radio frequency therapy to rejuvenate your youth. We can improve your airway to sleep and breath better. A total transformation of your teeth and gum health is also available from Dental Matrix.

DENTAL MATRIX CHINO HILLS
13850 City Center Drive, Suite 5000
Chino Hills, CA 91709
dentalmatrixchinohills@gmail.com
(909) 525-2525

Mon: 9:00am - 6:00pm
Tue: 9:00am - 6:00pm
Wed: 9:00am - 6:00pm
Thu: 8:00am - 6:00pm
Fri: 9:00am - 6:00pm
Sat: 9:00am - 5:00pm
Sun: Closed
Walk-ins and appointments are welcomed.
Contact us to request an 8:00am or 7:00pm appointment time.

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